Quitting smoking is even more important for people with type 1 diabetes as research suggests poor oral health can increase the chance of heart disease.

A recent study has shown adults with type 1 diabetes who smoke and develop gum disease (periodontitis) have a raised risk of coronary artery disease (CAD).

The University of Pittsburgh team’s small study involved 320 people with type 1 diabetes who had agreed to take part in the Pittsburgh Epidemiology of Diabetes Complications study.

All the participants had an oral health screening which showed that 34 people with type 1 diabetes had developed periodontal disease. When the researchers followed up with the volunteers during an average period of 19 years, they found 33.7% had developed CAD at follow-up, while 46.4% of those who smoked during their initial examination also had CAD.

Lead researcher Tina Costacou, an associate professor of epidemiology at the University of Pittsburgh, said: “These data suggest that in addition to good [blood glucose] control and treatment of high blood pressure, smoking cessation and oral health are important factors in reducing the development of heart disease.”

The researchers concluded that many people can be “unaware of periodontal problems until the disease progresses” which could then increase their chance of developing CAD.

They added: “Therefore, people with [type 1 diabetes] should be advised by their health care providers that [periodontal disease], in addition to smoking, places them at increased risk of [cardiovascular disease] complications beyond the traditional risk factors. These patients should be referred to a periodontist and placed on a periodontal treatment regimen.”

The findings have been published in Journal of Diabetes and its Complications.

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